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Endocrine > type one > Flashcards

type one Flashcards

1
Q

for a new patient assume 1-2 units of insulin will decrease FBG by

A

40-50 mg/dL

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2
Q

adjust one doe at a time unless

A

all glucose levels are greater than 200

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3
Q

initial dose of insulin

A

0.4-0.6 units/kg/day

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4
Q

honeymoon phase dose of insulin

A

0.1-0.4 units/kg/day

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5
Q

ketosis/infection insulin dose

A

1.0-1.5 units/kg/day

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6
Q

type two daily dose of insulin

A

0.7-1.5 units/kg/day

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7
Q

honeymoon phase

A

time period shortly after initiating insulin therapy when totally daily dose decreases

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8
Q

onset of honeymoon phase

A

within days to weeks after initial diagnosis

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9
Q

how long can the honeymoon phase last?

A

up to a year

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10
Q

TDD

A

insulin in a 24 hour period; half should be basal and the other half bolus

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11
Q

meal bolus

A

500 rule (500 divided by TDD

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12
Q

insulin sensitivity factor determines

A

how the patient responds to 1 unit of insulin

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13
Q

1800 rule

A

1800/TDD = how much one unit will lower BG

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14
Q

pattern management

A
  1. review several days of home BG readings
  2. do not react to single high or low
  3. nutrition education
  4. review all variables
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15
Q

simplest regimen for type one

A

2 injections a day (breakfast and supper)

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16
Q

2/3rd of total dose injected prior to

A

breakfast

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17
Q

1/3rd dose prior to

A

supper

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18
Q

first injection may be split

A

2/3rds NPH with 1/3rd regular or rapid insulin

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19
Q

can the second injection be split?

A

yes

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20
Q

which goes first, clear or cloudy?

A

clear before cloudy

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21
Q

regimen of two injections a day allows for

A

adjustment based on home BG readings

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22
Q

dawn phenomenon

A

rise in blood glucose levels between 4 and 8 am

23
Q

is dawn phenomenon caused by counter regulatory hormones secondary to hypoglycemia

A

no

24
Q

does dawn phenomenon happen in type one or type two

A

both

25
Q

dawn phenomenon means there is not enough insulin..

A

in the evening

26
Q

four injections a day

A

calculate TDD and divided 50/50 for basal and bolus

27
Q

best regimen without a pump

A

basal insulin with the patient CHO counting and correcting

28
Q

toujeo and Tresiba stability at room temp

A

56 days

29
Q

Novolog stability at room temp

A

14 days

30
Q

Humalog stability at room temp

A

10 days

31
Q

side effects of insulin

A

weight gain, nodules, lipohypertrophy, lipatrophy

32
Q

preferred site of injection

A

abdomen - most consistent rate of absorption

33
Q

where has the slowest rate of absorption

A

buttocks and thighs

34
Q

3/10 cc for doses

A

30 units or less

35
Q

1/2 cc for doses

A

31-50 units

36
Q

1 cc for doses

A

51 to 100 units

37
Q

typical length of needles

A

6 mm or short 8 mm

38
Q

typical gauge used

A

31 gauge

39
Q

nano pen needles

A

4mm, 32 gauge

40
Q

mini pen needles

A

5mm, 31 gauge

41
Q

6mm needles

A

6mm, 30 gauge

42
Q

short pen needles

A

8mm, 31 gauge

43
Q

monitoring therapy

A

home blood glucose readings, post prandial levels, A1C, hypoglycemic events, adherence

44
Q

LADA

A

slow onset T1DM or type 1.5

45
Q

LADA usually happens to those over age

A

30

46
Q

LADA is initially diagnosed as

A

type 2 DM

47
Q

treatment for LADA

A

may respond to oral agents, but will need insulin

48
Q

pramlintide

A

synthetic analog of amylin, deficient in diabetes

49
Q

MOA of pramlintide

A

inhibits postprandial glucagon secretion, slows gastric emptying, promotes satiety and reduces caloric intake

50
Q

when is pramlintide dosed

A

before meals, so reduce mealtime insulin by half initially

51
Q

increase dose of pramlintide if

A

no significate nausea for 3-7 days

52
Q

pramlintide type 1 dosing

A

15 mcg with a maintenance dose of 60mcg

53
Q

pramlintide type 2 dosing

A

60 mcg with a maintenance dose of 120 mcg

54
Q

contraindications of pramlintide

A

diagnosis of gastroparesis or hypoglycemia unawareness

Endocrine (7 decks)

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